Emerenziani Sara, Sifrim Daniel
Centre for Gastroenterological Research, Faculty of Medicine, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
Curr Gastroenterol Rep. 2005 Jun;7(3):190-5. doi: 10.1007/s11894-005-0033-x.
Total gastric emptying is delayed in 10% to 33% of adult patients with gastroesophageal reflux disease (GERD), but a strong correlation between duration of gastric emptying and severity of acid reflux or esophagitis has never been proved. Previous studies reported that patients with GERD might have exaggerated postprandial fundus relaxation with retention of food and triggering of transient lower esophageal sphincter relaxations (TLESRs). There is a positive correlation between postprandial fundus relaxation and number of TLESRs and also between proximal gastric emptying and esophageal acid exposure. However, new studies suggest that a high number of TLESRs and reflux events may occur even with accelerated gastric emptying, and prolonged gastric retention might be associated with less rather than more esophageal acid exposure. Using simultaneous gastric emptying and esophageal pH impedance we found that the rate of gastric emptying might determine the acidity and proximal extent of reflux: The slower the emptying, the higher the pH and proximal extent of the refluxate.
在10%至33%的成年胃食管反流病（GERD）患者中，胃排空延迟，但胃排空持续时间与酸反流或食管炎严重程度之间从未被证实存在强相关性。既往研究报道，GERD患者可能存在餐后胃底过度松弛，伴有食物潴留和一过性下食管括约肌松弛（TLESRs）触发。餐后胃底松弛与TLESRs次数之间存在正相关，近端胃排空与食管酸暴露之间也存在正相关。然而，新的研究表明，即使胃排空加速，也可能发生大量TLESRs和反流事件，而胃潴留延长可能与食管酸暴露较少而非较多相关。通过同步进行胃排空和食管pH阻抗监测，我们发现胃排空速率可能决定反流物的酸度和近端范围：排空越慢，反流物的pH值越高，近端范围越大。
